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目的:了解老年住院患者医院内下呼吸道感染(NLRTI)的现状、易患因素、病原菌分布和药敏的特点,为控制NLRTI的发生提供依据。方法:回顾性分析确诊为NLRTI的92例老年住院患者的临床资料。结果:NLRTI除年龄因素外,基础疾病、不合理使用抗菌药、各种侵入性诊疗等是主要的诱发因素;分离到的病原菌G~+菌占42.4%,主要以金黄色葡萄球菌、肺炎链球菌为常见,G~-菌占57.6%,以大肠埃希菌、肺炎克雷伯菌为常见;药敏试验显示G~+菌对万古霉素、克林霉素较为敏感,G~-菌对亚胺培南、阿米卡星普遍较为敏感。结论:对老年住院患者应尽量减少诱发因素及提高病原菌诊断水平,合理治疗是NLRTI防治的关键。
OBJECTIVE: To understand the status, risk factors, pathogen distribution and drug susceptibility of lower respiratory tract infection (NLRTI) in elderly hospitalized patients and to provide basis for controlling the occurrence of NLRTI. Methods: The clinical data of 92 elderly inpatients diagnosed as NLRTI were retrospectively analyzed. Results: In addition to age, NLRTI was the main predisposing factor for underlying diseases, irrational use of antibacterials and various invasive procedures. The pathogenic bacteria G ~ + accounted for 42.4% of the total, mainly Staphylococcus aureus, pneumonia Cocci were common, accounting for 57.6% of G ~ - bacteria, with Escherichia coli and Klebsiella pneumoniae as common; drug susceptibility tests showed that G ~ + bacteria were more sensitive to vancomycin and clindamycin, For imipenem, amikacin is generally more sensitive. Conclusion: The elderly inpatients should try to reduce the predisposing factors and improve the diagnosis of pathogenic bacteria. Reasonable treatment is the key to prevention and treatment of NLRTI.